Nursing Elites

1. A 52-year-old male patient is taking finasteride (Proscar) for benign prostatic hyperplasia (BPH). What patient teaching should the nurse provide?

• A. Take the medication with food.
• B. Avoid taking NSAIDs while on this medication.
• C. Avoid driving or operating heavy machinery while taking this medication.
• D. Women who are or may become pregnant should not handle crushed or broken tablets.

Correct answer: D

Rationale: The correct answer is D. Finasteride, used for BPH, can be harmful to a developing male fetus. Therefore, women who are or may become pregnant should not handle crushed or broken tablets to avoid potential absorption through the skin. Choice A is incorrect as finasteride can be taken with or without food. Choice B is incorrect because there is no specific interaction between finasteride and NSAIDs mentioned. Choice C is incorrect as finasteride does not typically cause drowsiness or impair mental alertness.

2. A patient with an 18 pack per year history presents to a family practice clinic complaining of painless hoarseness and inability to clear mucus. A biopsy of respiratory tract cells is taken and shows that these cells have been replaced by less mature squamous epithelium cells. The nurse knows this type of change is referred to as:

• A. Dysplasia
• B. Metaplasia
• C. Hyperplasia
• D. Coagulation

Correct answer: B

Rationale: Metaplasia is the replacement of one type of cell with another, which can occur in response to chronic irritation, such as from smoking. In this case, the respiratory tract cells being replaced by less mature squamous epithelium cells indicate metaplasia. Dysplasia refers to abnormal development or growth of cells, not replacement; hyperplasia is an increase in the number of cells, not a replacement; and coagulation is a process related to blood clotting, not cell replacement.

3. During childhood, the thymus decreases in size, and this is referred to as ______ atrophy.

• A. Physiologic
• B. Pathologic
• C. Disuse
• D. Neurogenic

Correct answer: A

Rationale: The correct answer is A, 'Physiologic.' Physiologic atrophy is a normal part of development, like the reduction in thymus size during childhood. Pathologic atrophy (choice B) refers to tissue wasting due to disease, not a normal process like the reduction in thymus size. Disuse atrophy (choice C) results from a lack of physical activity or stimulation, which is not the case with thymus size reduction. Neurogenic atrophy (choice D) is caused by damage to or diseases of the nerves supplying the muscles, not related to the thymus size reduction seen in childhood.

4. Which of the following are manifestations of Cushing syndrome?

• A. Truncal obesity with thin extremities.
• B. Enlargement of face, hands, and feet.
• C. Cachexia.
• D. Thick scalp hair.

Correct answer: A

Rationale: Truncal obesity with thin extremities is a classic manifestation of Cushing syndrome due to the redistribution of fat. Enlargement of face, hands, and feet is seen in conditions like acromegaly, not Cushing syndrome. Cachexia is a state of severe weight loss and muscle wasting, typically seen in conditions like cancer or advanced infections. Thick scalp hair is not typically associated with Cushing syndrome.

5. A nurse is teaching a patient about the use of testosterone gel for the treatment of hypogonadism. What important instruction should the nurse provide?

• A. Apply the gel after showering, and allow it to dry completely before dressing.
• B. Apply the gel to the genitals for maximum absorption.
• C. Apply the gel before bedtime to enhance absorption during sleep.
• D. Apply the gel to the face and neck for improved results.

Correct answer: A

Rationale: The correct instruction is to apply testosterone gel after showering and allow it to dry completely before dressing. This helps prevent the transfer of the gel to others and ensures proper absorption. Choice B is incorrect because the gel should not be applied to the genitals. Choice C is incorrect as there is no specific benefit to applying the gel before bedtime. Choice D is incorrect as the gel should not be applied to the face and neck for the treatment of hypogonadism.

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